Sabrina Josue underwent roughly 1,500 dialysis treatments over the past nine years before receiving the first kidney transplant at the new Queen’s Transplant Center.

The facility, which opened in March at the Queen’s Medical Center following the abrupt closure of the Hawaii Medical Centers and only organ transplant center in the Pacific, has completed four liver transplants in addition to the first kidney transplant eight days ago.

The Transplant Institute of the Pacific was shuttered when HMC’s Liliha campus went out of business in December, canceling scheduled surgeries and forcing numerous transplant hopefuls to fly to the mainland for organ and bone marrow replacements. Between 45 and 60 transplants were done each year at the center.

The 49-year-old Ewa Beach resident was overwhelmed with emotion at a news conference Monday as she spoke of her long ordeal and the shock that she still feels about finally receiving the lifesaving organ replacement.

"It has been a journey, but when the day finally came, words cannot describe how I feel and the gratitude I have towards the donor and their family," Josue said after being released Monday from the Queen’s Medical Center. "I’m forever grateful, and I’d do it again if I had to. It was worth the wait."

There are nearly 400 Hawaii patients awaiting transplants, mostly for kidneys.

"The biggest obstacle is the shortage of organ donors," said Whitney Limm, Queen’s vice president of clinical integration and formerly HMC’s kidney transplant director. "You live longer with a kidney transplant. The longer you wait for a transplant, the worse the outcome. About 5 percent of people die waiting for a kidney every year."

Hawaii consistently has the longest waiting time compared with the national average due to the higher rate of renal failure and inadequate number of donors, he added.

Most of the organs donated locally each year come from people involved in catastrophic accidents, according to the National Kidney Foundation of Hawaii. Those with chronic diseases such as cancer are ineligible to donate their organs.

"That’s what makes it difficult," said Glen Haya­shida, CEO of the National Kidney Foundation of Hawaii. "If you look at the total number of deaths in Hawaii, only a very small percentage would qualify."

Queen’s is hoping to receive approval next month from the United Network for Organ Sharing, a private nonprofit that manages transplants for the federal government, to begin pancreas replacements. The Centers for Medicare & Medicaid Services also must certify organ replacements since Medicare covers renal dialysis and transplants without an age requirement. Queen’s also is considering bone marrow transplants, a service not currently offered in Hawaii.

The cost of a kidney transplant ranges from $60,000 to $100,000, according to surgeon Linda Wong, who hopes to complete at least 20 replacements this year.

"For the last six months we were trying to rebuild the transplant center," she said. "When HMC closed at the end of December, we had no transplant center. This is historic because it’s the first kidney transplant done at Queen’s. There’s so many people waiting."

The state provided $1.5 million in seed money to help Queen’s quickly launch an organ transplant facility to replace the Pacific’s only transplant hub. The hospital matched the state funds for the estimated $3 million in startup costs, which included hiring staff and building renovations. Still, Queen’s has estimated the facility could cause $7 million to $8 million in losses in the first five years.

Josue, a former HMC receptionist who received a kidney from a local unnamed source, is looking forward to living a normal life again with her 20 grandchildren and nine children, free of dialysis treatments that tire her out three times a week.

"For the past nine years she couldn’t eat certain things and couldn’t drink (much)," said Josue’s husband, Derwin. "I don’t think this is the end of the road; it’s the beginning of the road. I’m excited about it."